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Abstract

Most health reform efforts focus on devising legal norms and procedures that will push the practice of health care professionals in the desired direction. In fact, although the law is a powerful influence on health care delivery and treatment decision-making, many health reform efforts that rely on changes in the law fail to produce the expected good effect. Experience teaches that there are many reasons a legal requirement can fail to work as expected. In health care, one occasion for slippage between good intentions and good outcomes for law reform is the transformation of legal standards through the formal and informal standards and procedures established within health care organizations.